<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>无标题文档</title>
<style type="text/css">
body {
	background-color: #FFF;
}
</style>
</head>

<body>
<p>&nbsp;</p>
<table width="830" border="0">
  <tr>
    <td width="190">领取人</td>
    <td width="202"><textarea name="textfield" id="textfield"></textarea></td>
    <td width="205">&nbsp;</td>
    <td width="215">&nbsp;</td>
  </tr>
  <tr>
    <td>领取方式</td>
    <td><textarea name="textfield2" id="textfield2"></textarea></td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td>领取时间</td>
    <td><textarea name="textfield3" id="textfield3"></textarea></td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td><input type="submit" name="button" id="button" value="提交" /></td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
  <tr>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
    <td>&nbsp;</td>
  </tr>
</table>
</body>
</html>
